Benefits of community-based demonstration efforts: Knowledge gained in substance abuse prevention

Prospective studies document that preventive interventions can reduce the prevalence of substance abuse and antisocial behavior. In contrast, the justification for community-based demonstrations in substance abuse prevention and mental health promotion assumes that communities have decided to invest in prevention and now wish to learn from the experience of others on how the value of this investment can be maximized. The expectation has been that demonstration grants can be applied to improve substance abuse prevention efforts operated under State and community auspices. A review of selected Knowledge gains from community-based demonstration programs for substance abuse prevention provides evidence for the position that communities have both benefited from and contributed to this type of knowledge development process on questions of the cost and effectiveness of specific categories of prevention activities, the timing and duration of interventions, and factors affecting implementation. Of these, the most rigorously-confirmed findings are: (I) that the transmission of generic life skills is associated with short-term reductions in substance abuse among adolescents; (2) that activities that improve self-esteem do not consistently affect adolescent substance abuse; and (3) that preventive interventions conducted among pregnant women motivated to participate produce net financial savings in hospital costs. (C) 2000 John Wiley & Sons, Inc.